Tags

Type your tag names separated by a space and hit enter

[Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic portal hypertension].
Cas Lek Cesk. 1996 Sep 18; 135(18):584-8.CL

Abstract

BACKGROUND

A transjugular intrahepatic portosystemic shunt (TIPS) is the creation of a percutaneous portosystemic anastomosis which is used as an alternative method of surgical portosystemic shunts and endoscopic treatment in the therapy of complications of portal hypertension. The objective of the present work was to summarize experience with TIPS in 100 patients.

METHODS AND RESULTS

In 1992-1995 the authors treated 100 patients with symptomatic portal hypertension by TIPS. To create the shunt in 84% patients a spiral Z stent was used, in the remainder a Wallstent. In 86% patients the indication for TIPS was haemorrhage associated with portal hypertension and in 14% refractory ascites. TIPS was implemented in 98% patients. The pressure in the portal vela was not reduced on average to 58% of the original value. Haemorrhage was not stopped in one of 7 patients. Haemorrhage from varices reappeared in 7% patients indicated on account of repeated haemorrhage and was always associated with the finding of chronic stenosis of the shunt. The mortality in conjunction with the procedure was 4%, the mortality within 30 days after operation was 8%. Uncontrollable encephalopathy developed in 3% of the patients. Primary patency of the shunt created by the spiral Z stent was 85% after 6 months, after 12 months 72% and thus does not differ from primary patency when Wallstents are used, as reported in the literature.

CONCLUSIONS

TIPS is an effective method to reduce the pressure in the portal vein in portal hypertension. The main limiting factor of the method is stenosis of the shunt due to hyperplasia of the neointima. Stenoses of the shunt can be effectively dilated by percutaneous balloon angioplasty.

Authors+Show Affiliations

Krajina A
Radiodiagnostická klinika, FN Hradec Králové.
Hůlek P
No affiliation info available
Eliás P
No affiliation info available
Michl A
No affiliation info available
Zizka J
No affiliation info available
Nozicka J
No affiliation info available
Vanásek T
No affiliation info available
Lojík M
No affiliation info available
Niangová I
No affiliation info available
Volfová M
No affiliation info available
Pozler O
No affiliation info available
Erben J
No affiliation info available
Papík Z
No affiliation info available
Bures J
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overChildEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHumansHypertension, PortalMaleMiddle AgedPortasystemic Shunt, Transjugular IntrahepaticPostoperative Complications

Pub Type(s)

English Abstract
Journal Article

Language

cze

PubMed ID

8998798

Citation

Krajina, A, et al. "[Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Treatment of Symptomatic Portal Hypertension]." Casopis Lekaru Ceskych, vol. 135, no. 18, 1996, pp. 584-8.
Krajina A, Hůlek P, Eliás P, et al. [Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic portal hypertension]. Cas Lek Cesk. 1996;135(18):584-8.
Krajina, A., Hůlek, P., Eliás, P., Michl, A., Zizka, J., Nozicka, J., Vanásek, T., Lojík, M., Niangová, I., Volfová, M., Pozler, O., Erben, J., Papík, Z., & Bures, J. (1996). [Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic portal hypertension]. Casopis Lekaru Ceskych, 135(18), 584-8.
Krajina A, et al. [Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Treatment of Symptomatic Portal Hypertension]. Cas Lek Cesk. 1996 Sep 18;135(18):584-8. PubMed PMID: 8998798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic portal hypertension]. AU - Krajina,A, AU - Hůlek,P, AU - Eliás,P, AU - Michl,A, AU - Zizka,J, AU - Nozicka,J, AU - Vanásek,T, AU - Lojík,M, AU - Niangová,I, AU - Volfová,M, AU - Pozler,O, AU - Erben,J, AU - Papík,Z, AU - Bures,J, PY - 1996/9/18/pubmed PY - 1996/9/18/medline PY - 1996/9/18/entrez SP - 584 EP - 8 JF - Casopis lekaru ceskych JO - Cas Lek Cesk VL - 135 IS - 18 N2 - BACKGROUND: A transjugular intrahepatic portosystemic shunt (TIPS) is the creation of a percutaneous portosystemic anastomosis which is used as an alternative method of surgical portosystemic shunts and endoscopic treatment in the therapy of complications of portal hypertension. The objective of the present work was to summarize experience with TIPS in 100 patients. METHODS AND RESULTS: In 1992-1995 the authors treated 100 patients with symptomatic portal hypertension by TIPS. To create the shunt in 84% patients a spiral Z stent was used, in the remainder a Wallstent. In 86% patients the indication for TIPS was haemorrhage associated with portal hypertension and in 14% refractory ascites. TIPS was implemented in 98% patients. The pressure in the portal vela was not reduced on average to 58% of the original value. Haemorrhage was not stopped in one of 7 patients. Haemorrhage from varices reappeared in 7% patients indicated on account of repeated haemorrhage and was always associated with the finding of chronic stenosis of the shunt. The mortality in conjunction with the procedure was 4%, the mortality within 30 days after operation was 8%. Uncontrollable encephalopathy developed in 3% of the patients. Primary patency of the shunt created by the spiral Z stent was 85% after 6 months, after 12 months 72% and thus does not differ from primary patency when Wallstents are used, as reported in the literature. CONCLUSIONS: TIPS is an effective method to reduce the pressure in the portal vein in portal hypertension. The main limiting factor of the method is stenosis of the shunt due to hyperplasia of the neointima. Stenoses of the shunt can be effectively dilated by percutaneous balloon angioplasty. SN - 0008-7335 UR - https://www.unboundmedicine.com/medline/citation/8998798/[Transjugular_intrahepatic_portosystemic_shunt__TIPS__in_the_treatment_of_symptomatic_portal_hypertension]_ DB - PRIME DP - Unbound Medicine ER -